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Liver transplantation in patients with HIV infection
Author(s) -
Fung John,
Eghtesad Bijan,
PatelTom Kusum,
DeVera Michael,
Chapman Holly,
Ragni Margaret
Publication year - 2004
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.20261
Subject(s) - medicine , immunosuppression , coinfection , liver transplantation , liver disease , hepatitis c virus , immunology , hepatitis c , calcineurin , human immunodeficiency virus (hiv) , viral hepatitis , transplantation , viral load , disease , virology , virus
Key Points 1 Liver transplantation for human immunodeficiency virus (HIV)‐positive patients with end‐stage liver disease in the era of highly active retroviral therapy has proven to be an effective treatment. The concerns of HIV progression have not been borne out by the growing worldwide experience. 2 CD4 counts are stable and HIV viral load is controllable with medication following liver transplantation. 3 Hepatitis C virus (HCV) coinfection in HIV‐positive recipients is universal, but the severity of recurrence does not appear to be different from that in HIV‐negative patients with HCV liver disease. 4 Complex pharmacokinetic interactions between the calcineurin inhibitors used for immunosuppression along with protease inhibitors are present, but management directed at recognizing the need for monitoring levels does not appear to increase the risk of toxicity. 5 The degree of immunosuppression from iatrogenic drug therapy and HIV does not lead to increased risk of infectious complications. (Liver Transpl 2004;10:S39–S53.)